Pain Management (cont.)

Standiford Helm II, MD

Dr. Helm has been practicing interventional pain management since 1982. Dr. Helm is a diplomate of the American Board of Anesthesiology with subspecialty certification in Pain Medicine and of the American Board of Pain Medicine. Dr. Helm is a Fellow of Interventional Pain Practice (FIPP), the only certifying agency which tests the ability to perform interventional pain procedures. Dr. Helm is also an examiner for FIPP.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Treatment of neuropathic pain

The various neuropathic pains can be difficult to treat. However, with careful diagnosis and often a combination of methods of treatments, there is an excellent chance of improving the pain and return of function.

Medications are a mainstay of treatment of neuropathic pain. In general, they work by influencing how pain information is handled by the body. Most pain information is filtered out by the central nervous system, usually at the level of the spinal cord. For example, if you are sitting in a chair, your peripheral nerves send the response to the pressure between your body and the chair to your nervous system. However, because that information serves no usual purpose, it is filtered out in the spinal cord. Many medications to treat neuropathic pain operate on this filtering process. The types of medications used for neuropathic pain include antidepressants, which influence the amount of serotonin or norepinephrine, and antiseizure medications, which act on various neurotransmitters, such as GABA and glycine.

One of the most powerful tools in treating neuropathic pain is the spinal cord stimulator, which delivers tiny amounts of electrical energy directly onto the spine. Stimulation works by interrupting inappropriate pain information being sent up to the brain. It also creates a tingling in the pain extremity, which masks pain.